QuizMe 2

Vaginal discharge

A 25 year old pregnant woman at 12 weeks gestation presented to the clinic with a new complaint of white vaginal discharge.It is associated with a fishy odor.She is medically free with no allergies. What do you think is the problem? How would you manage?

  • Fishy odor 
  • Pregnancy 
  • Absence of allergies

Bacterial Vaginosis 

Amsel’s Criteria: 

  • whiff-amine test (Potassium Hydroxide)
  • Speculum exam: thin white homogenous discharge that coats the walls of the vagina
  • pH > 4.5 
  • Presence of clue cells on microscopy of wet mound (if available)

Metronidazole 500mg PO twice daily for 7 days

Only if symptoms recur or are persistent 

Increased risk of preterm birth

  1. Amsel R, Totten PA, Spiegel CA, et al. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med 1983; 74:14.
  2. Brocklehurst P, Gordon A, Heatley E, Milan SJ. Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database Syst Rev 2013; :CD000262.
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